CD147 immunohistochemistry discriminates between reactive mesothelial cells and malignant mesothelioma

Our plain-English summary of CD147 immunohistochemistry discriminates between reactive mesothelial cells and malignant mesothelioma, by C. Pinheiro, A. Longatto-Filho, T.R. Soares, et al (Diagnostic Cytopathology, 2012).

The study

• Authors: C. Pinheiro, A. Longatto-Filho, T.R. Soares, H. Pereira, C. Bedrossian, C. Michael, F.C. Schmitt, F. Baltazar
• Journal: Diagnostic Cytopathology
• Published: 2012;40(6):478-83
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma (MM) is a rare form of cancer. Its histopathological diagnosis is very difficult, as it exhibits a number of different appearances that can be misinterpreted as metastatic invasion or atypical hyperplasia. Thus, there is an urgent need to identify adequate markers to distinguish between benign and malignant cells, allowing the implementation of appropriate therapies and, possibly, specific directed therapies. MM, like other tumors, show an increase in glucose uptake, due to high rates of glycolysis, inducing an intracellular overload of acids. In this context, monocarboxylate transporters (MCTs) emerge as important players, by mediating the transmembranar co-transport of lactate with a proton, thereby, regulating pH and allowing continuous glycolysis. Importantly, proper MCT expression and activity depend on its co-expression with a chaperone, CD147, which is associated with poor prognosis in cancer. Twenty-two samples including reactive mesothelial cells, MM, and atypical mesothelial hyperplasias were evaluated for immunoexpression of MCT1, MCT4, and CD147. Expression of these proteins was compared with GLUT1 as a new promising marker for MM. Although MCT isoforms were not differentially expressed in the two types of cytological specimens, CD147, as GLUT1, was almost exclusively expressed in MM. Both MCT1 and MCT4 are not able to discriminate between mesothelial reactive cells and mesothelial malignant cells, while CD147 was able to distinguish these two proliferations. If confirmed, besides being a good marker for identification of MM, CD147 may also be a target for therapeutical strategies in this rare type of tumor.

Copyright © 2012 Wiley Periodicals, Inc.

In plain English

This laboratory study tested whether staining for certain proteins could tell malignant mesothelioma apart from reactive (benign) mesothelial cells. The authors used immunohistochemistry on samples from 20 patients (16 men and 4 women): 11 with reactive mesothelial cells and 9 with mesothelioma, taken from one author's consultation files. They examined two lactate transporters (MCT1 and MCT4), their partner protein CD147, and GLUT1, a glucose transporter already proposed as a mesothelioma marker. MCT1 and MCT4 did not differ significantly between the benign and malignant samples. CD147 was positive at the cell membrane in 8 of 9 mesotheliomas (88.9%) versus 1 of 11 reactive samples (9.1%), P 0.001. GLUT1 showed the same split. For this level of discrimination the article reported a sensitivity of 88.8% and a specificity of 90.9%. The authors noted that CD147, unlike GLUT1, did not stain red blood cells. The authors concluded that CD147 is a valuable discriminator between benign and malignant mesothelial proliferations, but said the findings need further study. The study did not look at asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory immunohistochemistry study of archived cytology samples comparing marker staining in reactive mesothelial cells and malignant mesothelioma
• Who was studied: Samples from 20 patients (16 male, 4 female): 11 with reactive mesothelial cells and 9 with malignant mesothelioma, from one author's consultation files. The place and time period are not stated.
• Exposure: Not studied. The article measured protein markers (MCT1, MCT4, CD147, GLUT1), not asbestos or any other exposure. Asbestos is mentioned only in the introduction as background.
• Main results:
  • MCT1 and MCT4 expression did not differ significantly between benign and malignant samples. Membrane MCT1 was positive in 8 of 11 reactive samples (72.7%) and 9 of 9 mesotheliomas (100.0%), P 0.218. Cytoplasmic MCT4 was positive in 7 of 11 reactive samples (63.6%) and 7 of 9 mesotheliomas, P 1.000.
  • Membrane CD147 was positive in 8 of 9 mesotheliomas (88.9%) and 1 of 11 reactive mesothelial samples (9.1%), P 0.001.
  • GLUT1 showed the same pattern as CD147: positive in 8 of 9 mesotheliomas and 1 of 11 reactive samples, P 0.001. The article reports a sensitivity of 88.8% and a specificity of 90.9% in the sentence comparing CD147 with GLUT1.
  • None of the markers was associated with age or gender (data not shown). MCTs were not significantly co-expressed with CD147 (data not shown).
  • The authors found CD147 staining easier to interpret than GLUT1 because CD147 did not stain red blood cells, which matters in bloody effusions.
• The authors' conclusion: The authors concluded that CD147, like GLUT1, distinguished benign from malignant mesothelial proliferations, while MCT1 and MCT4 did not. They suggested that, if confirmed, CD147 could also be a possible target for treatment.
• Limitations the authors state:
  • The authors stated that their findings need further study to confirm their validity.

Topics

Medical terms in this study, explained in our Lexicon: Immunohistochemistry, Reactive Mesothelial Cells, Malignant Mesothelioma, Prognosis, Atypical Mesothelial Proliferation, GLUT1, Reactive Cells.

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